Acta clinica Croatica
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Acta clinica Croatica · Dec 2021
AMBULATORY EYE SURGERY AND ANTITHROMBOTIC THERAPY - NEW APPROACHES.
One of the most common surgeries in elderly patients is eye surgery. An increasing number of patients undergoing ambulatory eye surgery are on antithrombotic therapy. These drugs may increase the risk of perioperative bleeding associated with ophthalmic needle blocks and/or eye surgery. ⋯ A comprehensive review of the English-language medical literature search utilizing PubMed, Ovid Medline® and Google Scholar from January 2015 to December 2018 was performed. The database searches included studies providing evidence relevant to ambulatory eye surgery and perioperative antiplatelet medications and anticoagulants. Updated recommendations will be given for continuation, discontinuation, and modification of antithrombotic agents in order to optimize the management of antithrombotic therapies in outpatients scheduled for eye surgery.
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Acta clinica Croatica · Dec 2021
CONTINUOUS GLUCOSE MONITORING AND TYPE 1 DIABETES MELLITUS CONTROL IN CHILD, ADOLESCENT AND YOUNG ADULT POPULATION - ARGUMENTS FOR ITS USE AND EFFECTS.
Sensors for continuous glucose monitoring (CGM) in intercellular fluid are used as a contemporary method to achieve better control in type 1 diabetes mellitus (DM), which is best shown through lower glycated hemoglobin (HbA1c) levels. The aim of this study was to assess how many of our patients used CGM (parents were solely financing all the cost of the device) and what was the effect of CGM on the control of DM. Data were retrospectively collected from medical records of patients actively treated at the Division of Endocrinology, Diabetology, Pulmonology and Allergology, Department of Pediatrics, Sestre milosrdnice University Hospital Center. ⋯ The mean HbA1c level 6 months before the introduction of CGM was 8.2%±1.9 and after 12 months of CGM use it was 7.4%±1.2, which was a statistically significant improvement (p=0.026). Furthermore, our results demonstrated that the greatest improvement in HbA1c level was recorded in the groups of young adults (18-25 years) and youngest children (<12 years). We confirmed the efficacy of CGM in achieving better control of type 1 DM by significantly improving HbA1c levels in a population of highly motivated patients.
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Acta clinica Croatica · Dec 2021
PREDICTIVE FACTORS FOR SUCCESSFUL PROSTHETIC REHABILITATION AFTER VASCULAR TRANSTIBIAL AMPUTATION.
Lower extremity amputation is a very common amputation and successful prosthetic rehabilitation is a desirable outcome. The aim of this study was to determine which factors affect the success of prosthetic rehabilitation after transtibial vascular amputation. The study included 61 patients who had undergone transtibial amputation (mean age, 64.2±10.4 years; 50 (82%) males). ⋯ Multivariate logistic regression analysis was used to identify predictive factors of successful prosthetic rehabilitation. The model included all variables explaining up to 59.8% of variance, however, only age, absence of functional patency of the popliteal artery and compromised wound healing made significant contribution to the model. In conclusion, good general condition of the patient and sustained patency of the popliteal artery reliably led to clinical improvement and realization of full capacity of rehabilitation after below-knee amputation.
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Acta clinica Croatica · Dec 2021
Case ReportsDEEP SEPTIC PELVIC THROMBOPHLEBITIS - A LIFE-THREATENING CONDITION IN POSTPARTUM PERIOD.
Deep septic pelvic thrombophlebitis is a rare but potentially devastating complication in the puerperium. Early diagnosis and aggressive treatment of this postpartum complication is essential. We report a case of a 23-year-old multipara, who presented with persistent high fever and abdominal pain two days after delivery. ⋯ Streptococcus pyogenes group A was cultured from cervical swab. Treatment consisted of broad spectrum antibiotic therapy and low molecular weight heparin. She was dismissed for home care symptom-free fourteen days after delivery and referred to hematologist to diagnose the possible causes of thrombophilia.
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Acta clinica Croatica · Dec 2021
CLINICAL RELEVANCE OF EXTENDED PLATELET INDICES IN THE DIAGNOSIS OF IMMUNE THROMBOCYTOPENIA.
Immune thrombocytopenia (ITP) is an autoimmune disorder. Besides platelet count, immature platelet fraction (IPF) can be used as a tool to predict megakaryocytic activity in ITP patients. The aim of the study was to evaluate the utility of extended platelet indices in ITP diagnosis and their association with disease persistence and severity. ⋯ Pearson correlation revealed negative relationship between platelet count and IPF in all patient groups. With the advent of new, sophisticated hematologic analyzers, the IPF and other platelet parameters provide simple, reliable and easier tools for predicting platelet disorders such as ITP, and to some extent the disease severity. Besides IPF, the MPV and P-LCR seemed to predict disease severity, treatment responsiveness, and duration of the disease to some extent.